Arthroscopic Meniscal Repair Using the BioStinger

• Published in: Arthroscopy Vol. 21; no. 6; pp. 744 - 750
• Main Authors: Barber, F. Alan, Johnson, Donald H., Halbrecht, Jeffrey L.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01-06-2005; Elsevier
• Subjects: Absorbable Implants; Adolescent; Adult; Arthroscopy; Arthroscopy - methods; Bioabsorbable; Biological and medical sciences; BioStinger; Endoscopy; Female; Follow-Up Studies; Humans; Investigative techniques, diagnostic techniques (general aspects); Joint Instability - surgery; Knee Injuries - surgery; Knee Joint - surgery; Lactic Acid; Male; Medical sciences; Menisci, Tibial - surgery; Meniscus; Middle Aged; Orthopedic surgery; Polyesters; Polymers; Repair device; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tibial Meniscus Injuries; Time Factors; Treatment Outcome; Meniscus; Repair device; BioStinger; Bioabsorbable; Knee; Human; Prognosis; Meniscus-Repair device-Bioabsorbable-BioStinger; Device; Diseases of the osteoarticular system; Method; Nuclear magnetic resonance imaging; Anterior cruciate ligament; Arthroscopy; Orthopedic surgery; Treatment; Articular cartilage; Cohort study; Medical imagery; Skin; Endoscopy; Lactic acid; Semilunar cartilage; Technique; Repair
• ISSN: 0749-8063; 1526-3231
• DOI: 10.1016/j.arthro.2005.03.002

Purpose: Biodegradable devices are available for all-inside meniscal repairs. One device, the BioStinger (Linvatec, Largo, FL), is made of molded poly-L-lactic acid. The purpose of this study was to evaluate the effectiveness of and any adverse events associated with meniscus repair using this device.
Type of Study Nonrandomized prospective cohort study.
Methods: A prospective, consecutive, 3-center meniscal repair series using BioStingers (group 1), vertical inside-out sutures (group 2), or hybrid repairs combining BioStingers and sutures (group 3) was studied. Lysholm, Tegner, Cincinnati, and IKDC activity scores were obtained and clinical outcomes and adverse events documented.
Results: There were 85 patients who underwent 89 meniscus repairs with an average 26.5 months of follow-up. There were 47 BioStinger repairs (group 1), 29 suture repairs (group 2), and 13 hybrid repairs (group 3). The tear length was statistically greater for the hybrid repair group (
P < .5). There were 73 repairs associated with anterior cruciate ligament reconstructions and 12 repeat arthroscopies were performed. Meniscal healing failed in 6 knees (4 in group 1, 0 in group 2, and 2 in group 3). The meniscal healing failed in 7% of those associated with anterior cruciate ligament reconstructions. Mean Tegner scores improved from 2.8 to 6.3, the final IKDC activity score was 3.2 out of 4, the mean Lysholm score improved from 51 to 88, and the mean Cincinnati score improved from 44 to 84. Two BioStinger repair cases had joint-line tenderness from device migration confirmed by magnetic resonance imaging. No tenting of the skin or articular cartilage scuffing was observed.
Conclusions: The success rate for the 29 suture repairs was 100% and for the 47 BioStinger repairs was 91%. These preliminary results are consistent with other repair techniques.
Level of Evidence: Level II, Therapeutic Prospective Cohort Study.